On Monday WHO’s Emergency Committee gave official word that they voted to renew the Public Health Emergency of International Concern. They are likely teeing up for “the end” in 2023. The U.S. is far more confident in “the end” of the national emergency. On Monday, the White House announced that they are ending it in mid-May.
You wrote : "Sadly, I’m starting to see denial and wishful thinking." Starting?? Personally, I think that's been happening for some time. No masks, "it's over", "I stopped thinking about the deaths". I do agree that we need to figure out a way to adjust to the fact that it's not going away, but as someone who is high risk, I just feel increasingly isolated and stigmatized. Apparently people who mask on planes are being harassed.
I always appreciate your approach to delivering serious information with a practical acknowledgement of what works for real humans and how we truly behave. But I think this piece (and much of the greater conversation about whether this is an "emergency") really overlooks the very real data about not just the Long Covid we've heard about—ongoing sequelae like fatigue, brain fog, etc—but the amplified cardiovascular risks, the damage to multiple organ systems, the long-term degradation ofthe immune system. I feel we can't look at the Covid picture as an acute illness that causes lots of disruptions and inconvenience. It has to be acknowledged that we're setting up literally all of society for increased long-term health problems, and that we're also rapidly accellerating those problems for those who are already immunocompromised and/or at higher risk. This goes WAY beyond it being annoying to have your kid home from daycare and is actually a *humanitarian* emergency.
On the whole YLE has given us a comprehensive well grounded perspective in the evolution of the COVID pandemic. In my public health informed opinion I agreeit is appropriate that the "Covid Emergency" be brought to an end - extending it to May 11 is an act of generosity. This is because technically, scientifically, and in a public health sense across the country the case rate is low and there is now no surge and no new dangerous variants now or on the horizon. Also we probably have not yet reached endemicity. Case rates are low but the data is unreliable because of home testing. The current level of hospitalizations and deaths is low compared to the last three years (and may even never get lower.) Ongoing deaths will occur. Most importantly the general public (not to mention the Chamber of Commerce and the Republicans), having burnt out and been unsupportive and noncompliant when there were real risks with surges, will NOT want to pay attention now. There is no national political will or force to continue the emergency and plenty of corporate and Republican opposition.
The big problem is that the White House's policies and messaging is very deficient (to agree with the KFF observations cited). They have
(1) no announced and publicized public plan to monitor for a surge or dangerous variants (with transparent criteria and thresholds),
(2) no public plan to develop or approve a better vaccine on an accelerated basis (like the new, better Indian intranasal vaccine),
(3) no specific plan to increase vaccination acceptance and levels of Americans with the better booster,
(4) no public health strategy to protect high risk individuals (especially now that Evusheld is ineffective and off the market). They are not even articulating the importance of societal and neighborly protection of these 7 to 15 million Americans.
(5) no public, national plan to deal with deferred evictions,
(6) no national plan to deal with the 100,000s of people and children who will lose health insurance or be unable to afford ongoing home rapid tests or Paxlovid or vaccinations at commercial rates.
(7) Much NIH research but no plan to support people with LONG COVID now or to deal with the loss of their labor to the workforce,
(8) No plan to deal with the national trauma of over 1,000,000 deaths and the millions of affected family members. There is no discussion in the public square about this issue - like it never happened. (See MarkedbyCOVID.org).
(9) The COVID emergency totally demonstrated the shortcomings of our commercial, market oriented health care insurance by the need for the feds to bail out both providers and patients with huge amounts of federal cash to provide needed COVID medical care. We need to avoid any return to the old system and create a federal universal not for profit health care system on the traditional Medicare or a public utility model. It seems federal policy is unwilling to even admit this truth.
Thus there are lots of specific issues that concerned citizens and activists must pay attention to at this time of transition.
After reading this post, I became a subscriber. I have been reading for a while with appreciation but hesitated adding yet another subscription to my growing stack of expenses. But your willingness to be bold in speaking about the need for societal reform when it comes to healthcare pushed me here immediately. Thank you for your voice.
"We need to invest in better filtration and ventilation."
Has literally anything been done in this regard? I see a lot of talking about its necessity but have never seen anything talking about any progress, other than some schools buying portable air filters.
On an anecdotal note, I (childless) only see those filters in some medical settings and ... all over Koreatown. That's it. Is there any invisible progress being made?
As an individual, I can't solution for better filtration in public spaces, especially schools (because of how they're funded) and privately owned spaces (like big box stores and hospitals).
I am saddened that the recommendations given here fail to mention filtration at any other level of responsibility besides an individual's onus. This is a tremendous misstep.
Thank you for another wonderful post. I appreciate the thought you put around what phase we’re in given our uncharted territory and lack of formal definition.
Dealing with Covid is our new normal. What I struggle with is knowing how bad transmission levels are around me. What’s the most reliable indicator? In my country, the wastewater chart (logarithmic) is at an all-time high (worse than January 2021) even though our CDC score (based on hospital bed capacity) is “low.” We’ve had a ton of rain this past month, which makes interpreting the chart iffy. Deaths are also low, thankfully, but they are backwards looking by 3+ weeks. I’ve been trying to do as much social stuff as possible outside for the last 3 years, but at some point I’ll need to return to indoor dining and events. It would be nice to know I’m doing so when transmission levels are low - but where’s the best place to find this out? Case counts are no longer reliable, and test positivity isn’t always readily available.
I’m also curious, any update on XBB.1.5? Will we have a second winter surge, and if so, will it be worse than the post-Christmas wave? Or is our immunity wall holding up better than expected?
"At this rate, SARS-CoV-2 will be the fourth leading cause of death in the U.S. in 2023..."
This always bothered me. Heart disease and cancer aren't "one thing". They're a category of many different ailments, all lumped together. Accidents I have to assume are the same. Yet COVID-19 is a very specific single ailment. In previous years it looked fairly clear that one could declare COVID-19 the biggest single cause of death. Would be interesting to see when _that_ might finally stop being the case.
500 people a day. Thanks, as always, for painting a complete picture.
As we leave behind the emergency phase, it's so striking that COVID is Top 5 for causes of death, right above stroke! You're conclusion that we are also *LESS* prepared for the next pandemic due to lack of trust, misinformation, etc is quite sobering and should inspire us to do better.
Regarding the top 3 killers in this country, it would be interesting to see people’s behavior if we phrased it this way:
By getting vaccinated and boosted, and by being careful in crowded indoor spaces, you can reduce your risk of dying from Cancer by over 90%.
I would do that.
Same for heart disease. Accidents. If only it were that easy for these top killers.
It kind of is that easy, for most of us, with Covid.
Thank you for this helpful perspective. Yes, we will (hopefully) be in this in-between, transition phase for years to come. Please share if there are ways we can help to support improvements as we go forward. With gratitude.
NIce piece, but depressing in that "the emergency is over" thinking will end up increasing deaths still more. And while I agree that innovation in vaccines is needed, we also need to focus on developing drugs that *kill* coronaviruses. There was much optimism about this a year or so ago; now everything has gone quiet. Which is strange, because any research group or pharma company that develops such a drug will make a fortune. Might be nice to write a piece on the state of play WRT developing new ways to stop Covid, etc (not solely vaccines). Thanks Katelyn, and keep up the terrific work.
This is a great post - thanks! Can you write a follow-up post about living in this "transition" world with an individual-centric set of guidelines for navigating life - with the aim of aggressively minimizing the probability of encountering long-COVID in our lives?
Right now, all I can think of is that catching COVID is bad - because it *may* lead to long COVID with a 1/300 probability (like you've written about earlier). But it leaves me feeling exposed and without a sense of control. I know if I get influenza, there are certain things I can do to minimize complications - even though tamiflu may or may not work, it's worth taking; and even though post-viral syndromes exist even with influenza, it hasn't felt historically scary like this.
- Recently FDA has moved to change COVID-19 vaccination schedule to be annual, and you wrote about it recently. Are there strategies we could undertake get non-updated vaccines more frequently if we wished (perhaps with the help of a friendly physician's referral and out of pocket costs) to reduce our exposure?
- What are the best tactics for leveraging Paxlovid in our lives? I've read in some places that a 2-week course is more effective than a 1-week course, but it all sounds very anecdotal, and I've ignored it (we've avoided COVID-19 successfully, in part thanks to columns like yours, so haven't needed this yet).
- How do we manage travel, and in general, taking risks in environments where we may expose ourselves to COVID-19 (like restaurants, parties etc.)? Is the only solution to mask-up, and avoid flying to Australia? ;-)
As someone who recently tested positive for Covid after 2 1/2 years of cautious living I really appreciate your thorough and objective delivery of this information.
I had to fly from Calif to Florida to visit my brother in the hospital and on the flight home had a passenger on my left, masked , coughing and sneezing and on the right across he aisle I had a fellow umasked coughing and sneezing .
I was double masked most of the time unless single masked or eating. tested positive three days after getting off the plane.
I am fortunately having light symptoms and even though 73 I am in pretty good health and not experiencing severe reactions.
We are definitely NOT over the pandemic despite America's frightening ability to choose to believe what matches their wish list rather than what is actually occurring.
Like the captain on the Titanic, we continue to believe that we can transform this continuing serious Covid infection - "glacier" of a problem into a "fogbank" because we " want to". Just as with Climate Change, Homelessness , Racism, and the Income disparity, " Don't Look Up !" got it right!
Thanks for your work and commitment
I had hoped we'd get a decision about when vulnerable seniors, like me and my husband, can have our 2nd bivalent booster. Our first was 4 months ago. Advice, please! (No comments by pro-Covid folks are wanted.)